What does OH, NC & MD have in common?

Ohio, North Carolina, and Maryland  all had crashes involving ambulance's this month thus far. With all of these being in the news lately and it has caused me to do some reflection on my own driving. Whether its due to youth, our inexperience, the inability to handle the adrenaline, or other motorist faults, we are at risk. A constant risk of Motor Vehicle Crashes, some of which have ended with fatalities of civilians and EMS providers.

Emergency Medical Services unfortunately involves the use of Ambulances. Ambulance's which are on every city street, rural road, state route and interstate highway. Roadways which are occupied by various other forms of vehicles. Vehicles have a molecular attraction to each other, much like moths to a flame. Being in the ambulance is possibly the most dangerous yet consistent part of our jobs. Yet I dare say that it is the most overlooked when it comes to safety, not necessarily by the industry but by the providers.

There are new safety features and innovations when it comes to patient compartment restraints, new ideology for paint schemes including the American's introduction (and acceptance) to the chevron. Emergency vehicles are being equipped with the same safety features many new age passenger vehicles have. Along with the addition of Opticom's to give us the right of way at intersections, are all valiant attempts for safety. This way of thinking excludes what I'd argue is the biggest factor of the accidents, the Human Factor.

As the articles have shown, some times EMS is the human factor, sometimes the populous is the human factor and sometimes in the case of training an inexperienced individual its multiple human factors. Now there is little we can do to fix the populous other than public service announcements and the hope it sinks in. On the other hand we can strive for better self control and a stronger diligence towards the inexperienced while training them. The need for repetitive assessments of current practices and skills would go a long way. A strong need to re-mediate any and all practices we may not have a full remembrance about. This is not a supervisory or managerial assessment but rather the responsibility of each individual to protect each other. Self assessments and continual application of safety concepts would go a long way

A few remediation points hopefully to spark self awareness: 
1. Never drive above the posted speed limits going to or returning from an incident. 
Now this by far is the hardest for me to do. Though I understand the thought behind it. There are posted speed limits set forth by the state as to the operator of a vehicle to know at which speed he can safely operate at. Safe operation includes such factors as population, road size and road conditions.  I find it hard to travel the speed limit because I rarely do in my personal vehicle.


2. Wear a Seat Belt.
This goes for both while in the front of the vehicle or passenger compartment while vehicle is in motion. Though not directly related to the concept of this piece a good point to make anyway. 


3. Stop and Clear all traffic controlled intersections.
If being in the ambulance is potentially the most dangerous part of the job, it being in emergency transit and entering an intersection is death defying! The factors involved in a safe intersection transition are numerous and readily relies on others. Stopping and making sure all traffic is stopped before you enter the intersection is imperative to life.


Now in no way is this a fix all to this months crashes. Nor do I intend to place any form of blame, rather I hope I get you to think of how to make yourself safer on the next run you make. After all, Your life and others depend on it. 


Be Safe
Ambulance Junkie

What Would I teach Lizzie?

-The Handover-EMS Blog Carnival Aug. Submission-

So your proficient in your skills, able to back board with the best of them. Fully capable of putting on a traction splint, vacuum splint and can sling and swath a shoulder. You've studied all the acronyms needed, DCAP-BTLS, PERRL, SAMPLE, and have a solid understanding of their use as it pertains to the patient.

You have a sound understanding that majority of calls will fall in the "grey realm". You'll have some black & white calls laid before you, but over all you'll have an unproportional amount of grey calls. Understanding that once on the streets the clinical decision making is in your hands. You do not solely rely on your initial education, rather the trends in EMS you have been continually researching and the Con Ed classes participated in.

When all else fails Lizzie, you know when to call for help. People become afraid to show weakness in this line of work, but don't be. The simple fact is the nature of the beast that is medicine is ever changing and progressing. It is impossible to be on the cutting edge of every single change in EMS, but hopefully some one else may have the knowledge where you haven't gotten to yet. We must never forget that we are serving for one single reason, and that is to do whats best by the patient. Sometimes that means to ask for help, but you know that already.

Solid fundamentals, capable clinical decision making skills, and the ability to admit to one's self that you need help. That pretty much covers the whole lot of attributes a newly carded EMT will need for the field, and you have them.

So what do I hope I've taught Lizzie? Keep your sense of humor girl! This Career/Stepping stone/Hobby/Calling surrounds us with people having the worst day of their life potentially. We are always in the thick of their crisis, and are the ones they have summoned to help. That is a lot of pressure on an individual, to be the sole saver of life, the Grand Puba of help. the Sultan of Assistance. In order to maintain our sanity we have to be able to keep our sense of humor. Humor is really just a matter of perspective after all. When in the appropriate times it lightens our moods and gives us that little extra to make it another call.

But I'm sure you already knew that Lizzie, you were always a great student.

Be Safe
Ambulance Junkie